CourtsUpdated 25 Oct 2026
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Two court matters are in the news. The Supreme Court is looking at high mark-ups on cancer drugs. The Kerala High Court ruled on patents. The Centre has capped profit margins on 137 more cancer drugs. Families say these costs can push them into debt.
On 2026-09-28, the Kerala High Court ruled that the Centre can use a patent to make costly drugs for needy patients. On 2026-09-29, two Supreme Court judges criticised high mark-ups at a hearing. In October, the Centre capped trade margins at 30% on 137 more cancer drugs. Many reports call the hearing a ruling. Our sources show only remarks.
Some cancer patients pay over Rs 63,000 a month for targeted drugs, says The Guardian. It says some skip treatment, sell land or fall into debt. It also reports that medical costs push about 55 million people into poverty each year. The Indian Express puts one monthly cost at Rs 80,000.
Section 100 of the Patents Act, 1970 lets the Centre use a patented invention for government purposes. In 2026, the Kerala High Court held this includes making the drug and selling it to needy patients without profit. It read this with Articles 21 and 47 of the Constitution. It did not order the Centre to act. The Supreme Court mark-up case is pending. Our sources do not name the exact rule behind the 30% cap.
The Centre says the 30% cap will cut prices and save patients about 25 billion rupees a year. Congress leader Jairam Ramesh says the Centre has not used its patent powers. Drug companies argued in Kerala that Section 100 has a narrow scope. Access groups say leaving the choice to the Centre denies justice to patients.
The Supreme Court gave the government until 2026-10-27 to explain why caps should not cover all non-patented medicines. The Centre has not said whether it will use Section 100 for ribociclib or abemaciclib. The Kerala court set no deadline for the Centre to collect data. Our sources do not say whether anyone will appeal the Kerala ruling.
The causes and the earlier steps behind this issue.
Scroll.in says the Indian Patent Office once gave Natco a compulsory licence for the cancer drug sorafenib. Bayer held the patent. This showed that patent law can be used to cut cancer drug prices. Our sources give no year.
Reports say the Centre capped trade margins on 42 cancer drugs from 2019. Many other cancer drugs stayed outside the cap. Mark-ups continued on those drugs.
Sarojam Radhakrishnan, a retired bank employee, had metastatic breast cancer. She went to the Kerala High Court in 2022 over drug costs. She died in late 2022, but the case went on. It later centred on the patented drug ribociclib.
The government must tell the Supreme Court why caps should not cover all non-patented medicines.
The new prices for 137 cancer drugs are due next month. Sources differ on the exact date.
Watch whether the Centre announces use of Section 100 for ribociclib or abemaciclib.
Hard words used on this page, in plain English.
What the law or the rule says, in plain words. This page says what the law says, not who is right.
Section 100 lets the Central Government, or a person it authorises, use a patented invention for government purposes. In 2026, the Kerala High Court read it with Articles 21 and 47 of the Constitution. It held that this includes making the medicine and selling it to a needy patient without profit. The court left the choice to use it to the Centre and ordered no action.
These sections deal with compulsory licensing. This means letting another company make a patented drug without the owner's consent. The court-appointed adviser argued the Centre could use Section 100 or Section 92. Our sources show no court order on Section 92 in this matter.
The Centre has capped trade margins at 30% on 137 more cancer drugs. A trade margin is the profit added by distributors, hospitals and chemists. The Supreme Court mark-up case is pending, with a government answer due on 2026-10-27. Our sources do not name the exact rule or order behind the cap.
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The Centre says the 30% trade margin cap will cut prices of 137 more cancer drugs.
Evidence it cites
Reports say the cap already covered 42 cancer drugs from 2019. The Centre expects patients to save about 25 billion rupees a year.
Weak point critics raise
Critics say the Centre has not used its patent powers. Jairam Ramesh raises this point.
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On 2026-09-28, the Kerala High Court ruled that the Centre can use a patent to make costly drugs for needy patients. On 2026-09-29, two Supreme Court judges criticised high mark-ups at a hearing. In October, the Centre capped trade margins at 30% on 137 more cancer drugs. Many reports call the hearing a ruling. Our sources show only remarks.
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Some cancer patients pay over Rs 63,000 a month for targeted drugs, says The Guardian. It says some skip treatment, sell land or fall into debt. It also reports that medical costs push about 55 million people into poverty each year. The Indian Express puts one monthly cost at Rs 80,000.
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Section 100 of the Patents Act, 1970 lets the Centre use a patented invention for government purposes. In 2026, the Kerala High Court held this includes making the drug and selling it to needy patients without profit. It read this with Articles 21 and 47 of the Constitution. It did not order the Centre to act. The Supreme Court mark-up case is pending. Our sources do not name the exact rule behind the 30% cap.
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The Centre says the 30% cap will cut prices and save patients about 25 billion rupees a year. Congress leader Jairam Ramesh says the Centre has not used its patent powers. Drug companies argued in Kerala that Section 100 has a narrow scope. Access groups say leaving the choice to the Centre denies justice to patients.
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The Supreme Court gave the government until 2026-10-27 to explain why caps should not cover all non-patented medicines. The Centre has not said whether it will use Section 100 for ribociclib or abemaciclib. The Kerala court set no deadline for the Centre to collect data. Our sources do not say whether anyone will appeal the Kerala ruling.
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Cap on trade margins: 30% of maximum retail price Cancer drugs newly covered by the cap: 137 Average mark-up on some cancer drugs: 170% Extreme mark-ups found: Over 700% Example: price to hospitals, then to patients: Rs 2,700, then Rs 27,000 Expected yearly saving (most sources): 25 billion rupees New cancer cases a year in India: 1.56 million People pushed into poverty by medical costs a year: About 55 million Court deadline for the government: 2026-10-27
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Cancer drug prices and court rulings on mark-ups and generic medicines Two court matters are in the news. The Supreme Court is looking at high mark-ups on cancer drugs. The Kerala High Court ruled on patents. The Centre has capped profit margins on 137 more cancer drugs. Families say these costs can push them into debt. TIMELINE 2026-09-28: The Kerala High Court rules that Section 100 of the Patents Act lets the Centre make patented drugs for needy patients without profit. 2026-09-29: Two Supreme Court judges call some mark-ups on cancer drugs "extortion" at a hearing. 2026-10-02: The Indian Express reports that breast cancer patients paying Rs 80,000 a month see hope in the Kerala ruling. 2026-10-05: Congress leader Jairam Ramesh questions the Centre's delay in using patent law for patients. 2026-10-23: The Guardian reports that India has cut cancer drug costs by capping trade margins. 2026-10-24: bdnews24 reports the cap on 137 more cancer drugs and the court deadline. 2026-10-27: The government's deadline to answer the Supreme Court on caps for all non-patented medicines. THE BASICS What happened? On 2026-09-28, the Kerala High Court ruled that the Centre can use a patent to make costly drugs for needy patients. On 2026-09-29, two Supreme Court judges criticised high mark-ups at a hearing. In October, the Centre capped trade margins at 30% on 137 more cancer drugs. Many reports call the hearing a ruling. Our sources show only remarks. Why does it matter? Some cancer patients pay over Rs 63,000 a month for targeted drugs, says The Guardian. It says some skip treatment, sell land or fall into debt. It also reports that medical costs push about 55 million people into poverty each year. The Indian Express puts one monthly cost at Rs 80,000. What do the law and the Constitution say? Section 100 of the Patents Act, 1970 lets the Centre use a patented invention for government purposes. In 2026, the Kerala High Court held this includes making the drug and selling it to needy patients without profit. It read this with Articles 21 and 47 of the Constitution. It did not order the Centre to act. The Supreme Court mark-up case is pending. Our sources do not name the exact rule behind the 30% cap. What does each side say? The Centre says the 30% cap will cut prices and save patients about 25 billion rupees a year. Congress leader Jairam Ramesh says the Centre has not used its patent powers. Drug companies argued in Kerala that Section 100 has a narrow scope. Access groups say leaving the choice to the Centre denies justice to patients. What is still undecided? The Supreme Court gave the government until 2026-10-27 to explain why caps should not cover all non-patented medicines. The Centre has not said whether it will use Section 100 for ribociclib or abemaciclib. The Kerala court set no deadline for the Centre to collect data. Our sources do not say whether anyone will appeal the Kerala ruling. FACTS AND FIGURES Cap on trade margins: 30% of maximum retail price (The Guardian) Cancer drugs newly covered by the cap: 137 (bdnews24.com) Average mark-up on some cancer drugs: 170% (The Guardian) Extreme mark-ups found: Over 700% (The Guardian) Example: price to hospitals, then to patients: Rs 2,700, then Rs 27,000 (The Guardian) Expected yearly saving (most sources): 25 billion rupees (The Guardian) New cancer cases a year in India: 1.56 million (The Guardian) People pushed into poverty by medical costs a year: About 55 million (The Guardian) Court deadline for the government: 2026-10-27 (bdnews24.com) PERSPECTIVES Constitutional lens: The Kerala High Court tied government use of patents to the right to life and the State's duty on public health. - The court read Section 100 with Articles 21 and 47 of the Constitution. - Article 47 is the State's duty on public health. - The Supreme Court asked why caps should not cover all non-patented medicines. - Our sources show no constitutional challenge to the cap. Economic lens: Supporters of the cap point to high mark-ups and expected savings for patients. - The price regulator found average mark-ups of 170% on some drugs. - Some mark-ups were above 700%. - The Centre expects patients to save about 25 billion rupees a year. - bdnews24 gives a different savings figure, so sources conflict. Federal lens: The Kerala court placed the Section 100 decision with the Union (central) government, not the states. - The court called the use of Section 100 a policy choice for the Centre. - It asked the Centre to collect data on patients first. - Scroll.in says the ruling lets the Centre take the lead. Argued benefit for India: Supporters say the cap and the Kerala ruling could make cancer drugs cheaper and reduce family debt. - Cheaper drugs could mean fewer patients skipping treatment. - Ravi Kannan of Cachar Cancer Hospital welcomes the cap if more patients get drugs. - The Kerala ruling confirms the Centre has a legal route for costly patented drugs. Argued risk for India: Critics say the Kerala ruling may stay unused, because the court set no deadline. - The Leaflet calls the court's approach to Section 100 half-baked. - The Week says the right to treatment is protected only on paper. - Scroll.in says the ruling alone does not make any medicine cheaper. - Our sources do not describe risks to drug makers or supply. HOW WE GOT HERE Patent law used before: Scroll.in says the Indian Patent Office once gave Natco a compulsory licence for the cancer drug sorafenib. Bayer held the patent. This showed that patent law can be used to cut cancer drug prices. Our sources give no year. Cap covers only some drugs: Reports say the Centre capped trade margins on 42 cancer drugs from 2019. Many other cancer drugs stayed outside the cap. Mark-ups continued on those drugs. A patient goes to court: Sarojam Radhakrishnan, a retired bank employee, had metastatic breast cancer. She went to the Kerala High Court in 2022 over drug costs. She died in late 2022, but the case went on. It later centred on the patented drug ribociclib. Kerala court clarifies patent power: On 2026-09-28, the Kerala High Court held that Section 100 lets the Centre make patented drugs for needy patients. It left the choice to the Centre. It asked the Centre to collect data first. Supreme Court adds pressure: On 2026-09-29, Supreme Court judges criticised mark-ups at a hearing. In October, the Centre extended the 30% cap to 137 more cancer drugs. The government must answer the court by 2026-10-27. EACH SIDE'S CASE The Central government: The Centre says the 30% trade margin cap will cut prices of 137 more cancer drugs. - Evidence it cites: Reports say the cap already covered 42 cancer drugs from 2019. The Centre expects patients to save about 25 billion rupees a year. - Weak point critics raise: Critics say the Centre has not used its patent powers. Jairam Ramesh raises this point. Congress, led by Jairam Ramesh: Jairam Ramesh says the Modi government has not protected patients from costly medicines and has not used its patent powers. - Evidence it cites: He points to a Rs 74 injection selling for Rs 4,980. He says a 21-day course of one cancer drug costs about Rs 58,000. - Weak point critics raise: Our sources show no reply from the government or the BJP. The Kerala court said the Centre first needs data. Drug companies: Novartis argued that Section 100 applies only when the government itself needs the patent. Companies argued it has a narrow scope. - Evidence it cites: Novartis told the court it charges its lowest price in India. It also said a 30% cap already applies. - Weak point critics raise: The Kerala court rejected the narrow reading. It said Section 100 puts no limit on who the buyer can be. Patients and access groups: Gopakumar of the Working Group on Access to Medicines and Treatments says leaving the choice to the Centre denies justice to patients. - Evidence it cites: They point to Sarojam Radhakrishnan's case. Her 21-day ribociclib course cost Rs 58,140, says The Leaflet. - Weak point critics raise: The court said it lacked data on affordability. It said the government must collect that data first. WHO IS SAYING WHAT Maitreyi Sachidananda Hegde (Court-appointed amicus curiae in Kerala case): Says this is the first judgment to discuss Section 100 for very high prices of patented medicines. Gopakumar (Working Group on Access to Medicines and Treatments): Says leaving the decision to the Centre is a denial of justice. Warns the government may delay without a deadline. Ravi Kannan (Director, Cachar Cancer Hospital, Assam): Says the cap is welcome if more patients can get the drugs they need. Jairam Ramesh (Congress general secretary): Says the Centre has been slow to use patent law for patients. The Guardian (British newspaper): Stresses the human cost through one patient's story and the Supreme Court's "extortion" wording. The Leaflet (Legal news site): Stresses that the Kerala court did not order the government to act. Scroll.in (News site): Frames the ruling as a chance for the Centre to lead on affordable treatment. WHAT TO WATCH NEXT 2026-10-27: The government must tell the Supreme Court why caps should not cover all non-patented medicines. The new prices for 137 cancer drugs are due next month. Sources differ on the exact date. Watch whether the Centre announces use of Section 100 for ribociclib or abemaciclib. Watch whether the Centre or the companies appeal the Kerala ruling. Our sources do not say. WORDS EXPLAINED trade margin: The profit added by distributors, hospitals and chemists between the maker and the patient. patent: A legal right that gives a company the sole right to make a medicine for a set time. Section 100: A part of the Patents Act that lets the Centre use a patented invention for government purposes. compulsory licensing: Letting another company make a patented drug without the owner's consent. ribociclib: A patented breast cancer drug at the centre of the Kerala case. WHAT THE LAW SAYS Government use of a patent (Section 100, Patents Act, 1970): Section 100 lets the Central Government, or a person it authorises, use a patented invention for government purposes. In 2026, the Kerala High Court read it with Articles 21 and 47 of the Constitution. It held that this includes making the medicine and selling it to a needy patient without profit. The court left the choice to use it to the Centre and ordered no action. Compulsory licences (Sections 84 and 92, Patents Act, 1970): These sections deal with compulsory licensing. This means letting another company make a patented drug without the owner's consent. The court-appointed adviser argued the Centre could use Section 100 or Section 92. Our sources show no court order on Section 92 in this matter. The 30% trade margin cap: The Centre has capped trade margins at 30% on 137 more cancer drugs. A trade margin is the profit added by distributors, hospitals and chemists. The Supreme Court mark-up case is pending, with a government answer due on 2026-10-27. Our sources do not name the exact rule or order behind the cap. WHAT THE SOURCES SHOW Established: The Kerala High Court ruled on 2026-09-28 that Section 100 of the Patents Act lets the Centre make patented drugs for needy patients without profit. It did not order the Centre to act. The Centre capped trade margins at 30% on 137 more cancer drugs. Supreme Court judges criticised mark-ups at a 2026-09-29 hearing. Our sources show remarks, not a final order. Claimed by one side: The Centre says the cap will cut prices and save about 25 billion rupees a year. Claimed by the other side: Critics say the Kerala ruling binds no one to act. Jairam Ramesh says the Centre has not used its patent powers. Not yet decided: The government's answer to the Supreme Court is due 2026-10-27. Whether the Centre will use Section 100 is open. Sources differ on the savings figure and the monthly drug cost. SOURCES bdnews24.com - https://bdnews24.com/neighbours/3tdt754v36 The Guardian - https://www.theguardian.com/global-development/2026/oct/23/india-cuts-cost-cancer-drugs The South First - https://thesouthfirst.com/health/kerala-hc-centre-patented-medicines-too-expensive-how-will-it-work/ The Indian Express - https://indianexpress.com/article/health-wellness/kerala-hc-breast-cancer-drugs-section-100-patents-act-10903576/ The Week - https://www.theweek.in/news/health/2026/10/08/opinion-or-kerala-hc-decision-upholds-right-to-lifesaving-cancer-medication-but-only-on-paper.html The Leaflet - https://theleaflet.in/health/kerala-high-courts-half-baked-approach-to-section-100-of-the-patent-for-affordable-treatment-to-cancer-patients The Statesman - https://www.thestatesman.com/india/ramesh-targets-modi-government-over-costly-medicines-questions-delay-in-using-patent-law-for-patients-1503647356.html Scroll.in - https://scroll.in/article/1096267/cheaper-cancer-medication-kerala-hc-ruling-is-an-opportunity-for-centre-to-take-the-lead More: https://socialwire.in/issues/cancer-drug-prices-and-court-rulings-on-mark-ups-and-generic
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On 2026-09-28, the Kerala High Court held that Section 100 lets the Centre make patented drugs for needy patients. It left the choice to the Centre. It asked the Centre to collect data first.
On 2026-09-29, Supreme Court judges criticised mark-ups at a hearing. In October, the Centre extended the 30% cap to 137 more cancer drugs. The government must answer the court by 2026-10-27.
Watch whether the Centre or the companies appeal the Kerala ruling. Our sources do not say.
Jairam Ramesh says the Modi government has not protected patients from costly medicines and has not used its patent powers.
Evidence it cites
He points to a Rs 74 injection selling for Rs 4,980. He says a 21-day course of one cancer drug costs about Rs 58,000.
Weak point critics raise
Our sources show no reply from the government or the BJP. The Kerala court said the Centre first needs data.
Novartis argued that Section 100 applies only when the government itself needs the patent. Companies argued it has a narrow scope.
Evidence it cites
Novartis told the court it charges its lowest price in India. It also said a 30% cap already applies.
Weak point critics raise
The Kerala court rejected the narrow reading. It said Section 100 puts no limit on who the buyer can be.
Gopakumar of the Working Group on Access to Medicines and Treatments says leaving the choice to the Centre denies justice to patients.
Evidence it cites
They point to Sarojam Radhakrishnan's case. Her 21-day ribociclib course cost Rs 58,140, says The Leaflet.
Weak point critics raise
The court said it lacked data on affordability. It said the government must collect that data first.
Experts, public figures and news outlets, in how they frame it. Each is listed with a source.
Maitreyi Sachidananda HegdeAnalystCourt-appointed amicus curiae in Kerala case
Says this is the first judgment to discuss Section 100 for very high prices of patented medicines.
GopakumarGroupWorking Group on Access to Medicines and Treatments
Says leaving the decision to the Centre is a denial of justice. Warns the government may delay without a deadline.
Ravi KannanAnalystDirector, Cachar Cancer Hospital, Assam
Says the cap is welcome if more patients can get the drugs they need.
Jairam RameshPublic figureCongress general secretary
Says the Centre has been slow to use patent law for patients.
The GuardianNews outletBritish newspaper
Stresses the human cost through one patient's story and the Supreme Court's "extortion" wording.
The LeafletNews outletLegal news site
Stresses that the Kerala court did not order the government to act.
Scroll.inNews outletNews site
Frames the ruling as a chance for the Centre to lead on affordable treatment.
The Kerala High Court tied government use of patents to the right to life and the State's duty on public health.
Supporters of the cap point to high mark-ups and expected savings for patients.
The Kerala court placed the Section 100 decision with the Union (central) government, not the states.
Supporters say the cap and the Kerala ruling could make cancer drugs cheaper and reduce family debt.
Critics say the Kerala ruling may stay unused, because the court set no deadline.
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The Kerala High Court tied government use of patents to the right to life and the State's duty on public health.
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Supporters of the cap point to high mark-ups and expected savings for patients.
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The Kerala court placed the Section 100 decision with the Union (central) government, not the states.
10 of 15
Supporters say the cap and the Kerala ruling could make cancer drugs cheaper and reduce family debt.
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Critics say the Kerala ruling may stay unused, because the court set no deadline.
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Section 100 lets the Central Government, or a person it authorises, use a patented invention for government purposes. In 2026, the Kerala High Court read it with Articles 21 and 47 of the Constitution. It held that this includes making the medicine and selling it to a needy patient without profit. The court left the choice to use it to the Centre and ordered no action.
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These sections deal with compulsory licensing. This means letting another company make a patented drug without the owner's consent. The court-appointed adviser argued the Centre could use Section 100 or Section 92. Our sources show no court order on Section 92 in this matter.
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The Centre has capped trade margins at 30% on 137 more cancer drugs. A trade margin is the profit added by distributors, hospitals and chemists. The Supreme Court mark-up case is pending, with a government answer due on 2026-10-27. Our sources do not name the exact rule or order behind the cap.
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Established: The Kerala High Court ruled on 2026-09-28 that Section 100 of the Patents Act lets the Centre make patented drugs for needy patients without profit. It did not order the Centre to act. The Centre capped trade margins at 30% on 137 more cancer drugs. Supreme Court judges criticised mark-ups at a 2026-09-29 hearing. Our sources show remarks, not a final order. Claimed by one side: The Centre says the cap will cut prices and save about 25 billion rupees a year. Claimed by the other side: Critics say the Kerala ruling binds no one to act. Jairam Ramesh says the Centre has not used its patent powers. Not yet decided: The government's answer to the Supreme Court is due 2026-10-27. Whether the Centre will use Section 100 is open. Sources differ on the savings figure and the monthly drug cost.